You made it! Congratulations on conquering the first 2 sections on Systems Medicine. And it will have been well worth your effort. Now that you’ve prepared the landing and oiled the gears, you are poised to tackle the final section. Here you will learn more about how to apply some basic principles of systems medicine to your own life. You will also better understand some future goals and targets for medical science research in our ever-evolving attempt to understand health and disease in complex living systems.
Our Best Solutions are Hiding in Plain Sight
Imagine for a minute that you are the owner of a big factory producing many different types of high-end goods. Your business has really taken off in the last few years and you’ve been struggling to keep up with the workload. Lately, you are increasingly worn out and the demands are taking a toll. Now, imagine also that you have a robot that works on the main level of your factory sorting packaging labels. It stands there, day in and day out, just sorting labels. Everyone you know with one of these robots - and they’re quite commonly employed it turns out - uses it for sorting labels, so you never bothered to imagine it could do much else. Until one day you come across the user’s manual (doh! Should have read that earlier!) for your robot. You discover that this unassuming machine is actually an advanced and dynamic precision tool that, although it is still quite capable of sorting labels, is also able to hold intelligent international conversations with your suppliers, manage your finances, clean up around the factory, and even do the maintenance work on all the other machines in your factory. You just never knew how to ask it to do all this. You feel scandalized, deceived, and yet invigorated by this newfound elegant solution to so many of your previous problems! You wonder: how on earth could so many people be using this impressive machine just to sort labels all day?!
The label-sorting robot we are talking about here is the most powerful base for your metabolic function. It is hiding in plain sight, being used every day to complete seemingly mundane tasks the way everyone around you appears to use it to complete mundane tasks.
It is your food.
But hold on.
We aren’t simply talking about following generic national dietary guidelines and recommendations such as My Plate (20). We aren’t talking about laboriously counting calories. We aren’t even talking about anything on the long list of marketed fad diets you could find with a wave of the Google search wand.
We are talking about harnessing whole food’s unparalleled capacity for superior therapeutic application in customized medical nutrition therapy for individual cases of metabolic dysregulation.
Every way you’ve been taught to see food as only “fuel” or “calories”, bought into one or more fad diets or “detoxes”, followed generic nutrition recommendations offered by well-meaning but nonetheless unequipped healthcare practitioners, or considered a cabinet full of nutritional supplements equivalent to whole food is a way you’ve neglected your most advanced and capable machine, leaving it to sort labels. Let’s wake up and see exactly what this truly magnificent tool can do for us.
Breaking it Down
Nutritional biochemistry is nearly synonymous with metabolic biochemistry. The metabolic pathways themselves run on nutrient cofactors; cells and tissues are structured with nutrient-based building blocks; powerful chemical messengers including hormones, neurotransmitters, and even immune-regulating compounds are driven by nutrient-based input; genetic expression, oxidative status, energy production - all regulated by the presence of nutrient-based or nutrient-derived molecules. In fact,
you will fail to find even one single physiological function that doesn’t directly rely upon a metabolic process that is coupled with nutritional status in some way (7).
This means that customized nutritional medicine is an inimitably powerful treatment tool for your metabolic health and ought to be thought of as the irrefutable and irreplaceable foundation of medical management, especially for chronic disease. Yet, both traditional and “alternative/holistic” physicians, PAs, nurses, psychotherapists, acupuncturists, herbalists, etc receive little to no formal training in customized whole foods-based medical nutrition therapy for individuals. Many practitioners claiming nutrition wisdom and formal nutrition education often mistakenly learned that supplements (including herbs and isolated nutrients) can be used in place of whole foods with equivalent success. Wrong! Isolated and concentrated supplements are not the same as whole food. Supplements do not make up for foundational dietary inadequacies (8). Furthermore, isolated and concentrated molecules found in supplements are more likely to increase detrimental side-effects than their whole food counterparts (9, 10). Though registered dietitians are the reigning specialists in applying customized medical nutrition therapy and frequently understand and emphasize the benefit of whole food over supplements in building nutrition foundations in clinical care, it is not uncommon to find many of them still unaware of the true scope of nutrition’s clinical and therapeutic power.
Whole food-based (meaning minimal reliance upon supplements and drugs and when/if used, ideally applied only after customized whole food foundations have been solidly laid) metabolic medicine is uniquely adept at addressing systemic dysregulation due to the fact that whole food is itself an interconnected system of hundreds or thousands of synergistic components that the interconnected system of our own body evolved in step with over thousands of painstaking years of evolution. They are deeply complementary systems in the truest sense. And though we build self-driving cars and send people into outer space, we have yet to replicate in a lab even the simplest of whole foods to its fullness. Supplements are not whole food and they should not be expected to perform similarly in therapeutic scope. We will be exploring a number of detailed case studies that poignantly illustrate this precise folly in future posts.
Of course drugs, supplements, and other lifestyle factors hugely impact the metabolic framework and can themselves hugely influence metabolic function. However…
The question is, given a certain drug, supplement, or lifestyle factor:
does it effectively treat or appreciate the full scope of the present metabolic dysregulation in someone?
does it have a plan for how to identify and correct any precursor or “up stream” imbalances that could be likely to persist or worsen even if a "down stream" point is targeted in isolation?
does it understand relevant biochemical relationships along the metabolic superhighways effectively?
does it understand the metabolic cost of its use and are those costs better or worse than the costs of another possible treatment?
Drugs and supplements certainly have their very effective place in optimal metabolic medicine and they can be life-saving at times. But when they are used to treat a seemingly isolated derangement in a particular point in a given metabolic pathway - especially over a long period of time - they may not only fail to address what caused the derangement to begin with, but may also minimize the larger implications of their presence in the metabolic machinery - increasing the risk that they may make the net effect of treatment worse, not better.
Appreciation of lifestyle factors including early childhood abuse or formative nutrition status affecting genetic/epigenetic components of neuroendocrine regulation (11), environmental exposures (pollutants, etc), exercise/rest, socioeconomic dynamics, behavioral therapies, mindfulness, etc is extremely important. These are all capable of impacting the metabolic machinery and we must appreciate their combined effect when fleshing out a systems-based metabolic medicine protocol. How these are managed in conjunction with customized whole foods-based medical nutrition therapy will dictate much about the success of disease prevention efforts or recovery from illness. Just like it would be crazy to expect someone to meditate their way out of nutrient deficiency-induced brain damage, it is equally crazy to expect someone to eat in such an optimal way as to wholly offset the detrimental effects of living in unbreathable levels of air pollution or enduring constant emotional and physical abuse from a spouse.
Cases of psychiatric and mood disorders, including bipolar, anxiety, depression, and disordered eating, are particularly intriguing when we try to understand the conundrum of the chicken or the egg in metabolic medicine. It’s important to understand that cognitive function isn’t special in that, just like every other part of our body, it relies on metabolic pathways. If we think about how nutritional status so heavily impacts cognitive function, including cognitive disease and behavior, it becomes immediately apparent that long-term behavioral modifications and mood disturbances are unlikely to be fully addressed without it (12, 13, 21, 22, 23, 24, 25,26).
As we’ve already learned, the term "neuroendocrine" is a synonym for "stress-response system". This is a system implicated in the economics of adaptation and metabolic stress management. In other words, it is the system at the heart of adapting to physiological stressors that are themselves metabolic in nature (13).
The term “decompensation" is defined in medicine as the functional deterioration of a structure or system that had been previously working with the help of allostatic compensation (13). As researchers state:
“The mechanisms underlying physiological regulation and dysregulation are likely to have important implications for health and disease. In broad terms, we suggest that allostasis be considered a dysregulatory (or disordered) form of physiological regulation that involves effector loops that over-respond in magnitude or duration and/or that compete concurrently with other effectors “ (14)
What does this mean? It’s sufficient to grasp that the body consists of a complex network of regulatory biochemical pathways (and loops) working to sustain your life. Whether we use the words “decompensation” or “allostatic compensation” or “dysregulation”, our goal is to convey a spectrum of compensatory maneuvers on the part of the body’s adaptation system that may eventually evolve into more advanced decompensation patterns resulting in systemic breakdown and loss of function. This spectrum as a whole not only utilizes the metabolic pathways as part of its etiology, but may have additional and cumulative widespread impact (largely negative) on these pathways of response and adaptation. Meaning, it’s a 2-way street of dysregulation. Dysregulation-begetting-dysregulation. But how does the breakdown happen? The simplest answer is that our metabolic demand has exceeded our metabolic reserves, and often for long periods of time:
Demand > Reserves
Robbing Peter to Pay Paul
When metabolic demand exceeds metabolic reserves, systems of adaptation may falter, imbalance and disease often following. What are the metabolic reserves of the body? Often, they are nutritional in nature, though we can think of them as having to do with a number of restorative functions, including adequate rest and reprieve involving activation of the parasympathetic nervous system (PNS). The PNS is a kind of antagonist to the sympathetic nervous system (SNS), the latter being what gets activated in times of increased demand, or stress, on the body. The PNS supports functions such as sexual arousal, salivation, urination, and digestion. It is also thought to have a number of important supportive consequences for immune function.
When the body experiences even borderline nutrient deficiency, it may “rob Peter to pay Paul”, triaging nutrients in a way that may leave many functions necessary to health neglected (27). However, if the response to this is to think you must saturate the body with high doses of micronutrients, think again. Recall that the body’s sense of health and well-being follows the U-shaped curve, with excess and deficiency causing similar symptoms of metabolic dysregulation. When in excess, for example, beneficial antioxidants such as vitamin E and C may become pro-oxidative (11, 28). The related presence of toxicity or adverse reactions in elevated doses of other micronutrients is so well-documented as to be needless for me to recount in detail here (35). The potential impact of nutritional imbalance - reflecting both deficiency and excess - on the state of metabolic health, including systemic dysregulation, should not be underestimated.
Finding the center of the U in terms of nutrient status for an individual may defy generic recommendations, since there is profound biochemical diversity in populations. One person’s center-of-the-U is another’s excess, or yet another’s deficiency. The “fire hose” approach to taking monotonously-dosed daily nutritional supplements to reduce risk of dietary deficiencies will be very unsuited to the delicate balance of our U-shaped curve, which flexes over time and does so alongside changes in the many other factors contributing to our metabolic health. Before we get into more practical details regarding the many therapeutic approaches to locating the center of the U in individuals, we need to talk more about some of the predictable patterns of metabolic dysregulation that can take place as demand exceeds reserve over time.
Decompensation: a Sliding Scale?
We don’t yet have a formal consensus in the literature as to the documentation of every deranged pattern taking place in conditions of systemic metabolic dysregulation. We also don’t yet understand the full extent to which the neuroendocrine system perpetuates this vicious cycle of chronic illness and imbalance. However, we may still begin to sketch some educated physiological outlines that have tremendous clinical utility and will necessarily continue to be explored in the research over time.
Recall that the term “decompensation” describes a functional deterioration of a structure or system that had been previously working with the help of allostatic compensation. “Metabolic decompensation”, as previously stated, has been historically reserved for very specific and acute cases of metabolic collapse that often unfold in the presence of Inborn Errors of Metabolism (IEM) and often lead to death if not treated immediately. There appears to be very limited exploration of how similar decompensation terms and processes extend to other areas of systemic dysfunction beyond IEM and may take place, albeit on comparatively less acute and more chronic scale.
In the case of many chronic disease states, I propose that it may be useful to extend the scope of the term metabolic decompensation to include a larger pool of metabolic regulatory defects with or without genetic etiology that may nonetheless result in progressive loss of function and failures to adapt on a systemic level over time. Due to the involvement of the neuroendocrine system in processes of adaptation and compensation (or decompensation), it may further seem prudent to utilize the term "neuroendocrine decompensation" for greater specificity in diagnostics and treatment as well as future research targets.
The important thing for clinical interest is to identify dysregulatory patterns emerging indicating functional failure to right the system once a certain stressor has been applied. Though the famous Hans Selye is credited as the first to articulate a theory of stress, adaptation, and disease (29), many have built their research atop his, critiquing and re-imagining it over time (4, 5, 30). Much of this collective commentary in the literature is impressive, though the absence of a deeper understanding of metabolic science and specifically the application of nutritional medicine in treatment is felt. This lack is partly due to the extraordinary difficulty in doing quality nutrition research, the notable lack of resources and funding available for whole foods-based experimental nutrition study designs, and other barriers (32).
Putting it All Together
Though it is beyond the scope of this series to list all current knowledge and clinical expertise regarding the application of every detail of customized metabolic medicine utilizing a combination of whole foods-based nutrition therapy and lifestyle factor modification, there are some quick-and-dirty pointers that everyone can benefit from and I’ve listed them below. For those wanting to do an even deeper dive, stay tuned for my full-length book to be published within the next year.
Quick-and-Dirty Guide to Customized Metabolic Medicine
What will work for you almost certainly won’t work exactly the same way for anyone else. You are profoundly biochemically unique. As such, expect generic prescriptions of diet, exercise, medication, and supplements to fail to capture the center of YOUR U-shaped curve, and thus, your optimal state of health. Your body offers daily clues in the form of symptoms that indicate where you are in your U-shaped curve. Identifying and interpreting these clues accurately over time is what guides and dictates successful treatment.
What will work for you will change over time, based upon the larger context of your life’s stressors, illness staging, and recovery progress. You can see this as the center of your U shifting somewhat over time
A full and complete picture of what will work for you is not something you’ll learn from any test we currently have. “Treating to the test” is one of the biggest mistakes made in medicine. Laboratory reference ranges may be able to tell you how to stay out of the extremes but they cannot tell you where in a given range you’ll feel your best or where some of your subclinical (meaning, a lab value shows “normal” on a test while you still show symptoms of the disease; commonly a problem in hypothyroidism) symptoms will be resolved.
Finding the Center of the U in nutrition will involve building a comprehensive detailed whole foods-based set of menus supplying appropriate amounts and types of nutrients for your estimated level of current GI function/digestive capacity, tolerance, and expected deficiencies or excesses. This is best done initially with a trained professional such as a registered dietitian nutritionist (RDN). Avoid seeking quality nutrition advice from practitioners with little to no formal or accredited training in nutrition science, as these individuals will not have the advanced training in manipulating nutritional biochemistry (predominately through whole foods with less emphasis on supplements) required to assess and manage you properly. This RDN should also be able to teach you how to become more independent with your self-navigation over time, utilizing the skills you’ve learned together regarding how to correlate your symptoms with the metabolic changes elicited by your customized nutrition plans alongside a lifestyle-based supportive coaching.
These customized menus will be appropriately dosed in types, portions, and combinations of foods/beverages and are generated from an in-depth understanding of your unique medical history, food access, socioeconomic limitations, illness staging, etc. This plan will be adapted and altered over time according to your body’s symptom response markers. Symptom response markers are not strictly laboratory test-dependent! They are your own body’s unique way(s) of communicating imbalance and cannot be quantified in totality from any current lab test. They reflect tolerance/intolerance to treatments as well as overall illness staging and health status. Symptoms that are frequently tracked as biological indicators of metabolic function and commonly reflect intolerance to different food types, amounts, or frequencies (as well as medication and supplement dosages or other lifestyle prompts) include
Fatigue, insomnia, aggravation of skin disorders, autoimmune flares, digestive upset (constipation, diarrhea, reflux, bloating, etc), body and joint pain, anxiety/depression, hormonal imbalances, weight status and fluctuations therein, as well as others
Create opportunities for contrast. This means that you don’t do the same thing with foods and supplements or activities every day. You vary your routine in predictable patterns. You rotate foods and supplements in predictable and patterned ways that allow your body breaks. You generate opportunities to see how your body feels with vs without something. Redundancy of metabolic prompts (including eating the same foods or taking the same supplements every day) can be a big mistake. Likewise, haphazardly doing something different every day without any meaningful pattern will also fail to grant you any worthwhile insights.
Titration. The devil is in the dose, as they say. The difference between tolerance and intolerance to a given food or other substance/metabolic prompt is often just a matter of dose and is far less black-or-white than many people have come to believe. Titration is a methodical way of starting very small and increasing an amount of a given item over time, bit by bit, until you reach a threshold tolerance level, at which point you back off. Your symptoms will often let you know when you’re at tolerance. At or just before the threshold point, you are very often in the Center of the U for your body. Specific examples of titrations will be explored in future case studies.
Periodic reassessment throughout time to include checking in with labs, methodically challenging new foods that were previously not tolerated, subtracting or adding any necessary metabolic prompts such as increased exercise frequency and intensity as appropriate and altering dosages of medications no longer needed. The therapeutic contribution of certain herbal-based bioactives may be explored in some cases with greater tolerance and success at the point where the underlying foundation of nutrition therapy has already been laid.
Conclusion: Assessing Your Current Healthcare Team
When multiple levels of metabolic dysregulation unfold in the body, it leaves most practitioners very confused. Many physicians and equivalent medical professionals do not have extensive training in practical metabolic biochemistry - which, as you now understand, is itself the language of the system as a whole. Metabolic biochemisty (of which nutritional biochemistry is an integral part of) is not something they study much at all unless they go on to pursue additional master's or PhD specialties in the specific field. Even then, clinical application knowledge beyond the lab may be limited. Naturopathic and IFM physicians, while studying nutrition slightly more than so-called traditional physicians, receive only minimal nutritional biochemistry training and their training in practical nutrition mostly focuses on applying nutritional or herbal supplements to “spot treat” various conditions. Even Chinese Medicine (including acupunture and herbs), which utilizes an alternate conceptual paradigm from western science but may nonetheless deliver some effective treatments for some conditions (36), does little to sway the overarching conceptual primacy of the biochemistry of the living system.
I have seen hundreds of patients arrive at my doorstep only after they have exhausted every other medical avenue and are ready to throw in the towel. Why is it only during the last stretch on the recovery path that they encounter more advanced customized nutrition therapy? Customized nutrition therapy is not the first stop. Your doctor’s office is. There, you’ll find a primary care doctor who often barely recalls basic college biochemistry and even if he/she does manage to inquire about your diet, still won’t be able to offer the time or tools required to thoroughly assess your full nutrition status. Even physician specialists may fail you. There are far too many gastroenterologists, gynecologists, endocrinologists, psychiatrists, internists, naturopathic physicians, etc, who frequently fail to investigate deeper seemingly obvious metabolic dysregulations (and their causes, including nutritional in nature) in their patients. As a patient you may have had the misfortune to experience one or more of the following failures in our medical system:
Gastroenterologists who specialize in pathologies of the GI tract and who would happily surgically reroute intestines but who never once ask their patient what he/she is eating or do a thorough dietary analysis. Do they not understand the evidence for nutrition’s overwhelming impact on GI health (14,15,16,17)?
Gynecologists who encounter a patient with PCOS and simply place her on hormonal contraceptives and/or Metformin - both of which have multiple drug-nutrient interactions that can further exacerbate nutritional, and thus, systemic metabolic imbalances - rather than utilize the emerging research linking dietary interventions with success in treating PCOS with or without medication (18). They appear so unaware of the side effects (including nutrient-related side-effects) of these drugs as to frequently fail to offer even minimal coaching and caution to their patients regarding such treatment.
Psychiatrists who see patients with mood disorders and who will place many of them on a regular dose of psychoactive medication such as a benzodiazapene or an SSRI as a first line of treatment but never bother to once ask their patient what he/she is eating or refer to a trained dietitian who could perform this task in their stead. These psychiatrists appear to not understand the evidence for nutrition’s overwhelming impact on mood and cognitive disorders (19,12, 13, 21, 22, 23, 24, 25,26). These very drugs they prescribe may actually cause more harm than good to the metabolic health of many of their patients over the long term.
Naturopathic and IFM physicians who market themselves as “alternatives” to these arguably unethical aforementioned cases but who will still charge their desperate patients hundreds or even thousands of dollars to run expensive and largely unnecessary functional tests that will only result in the sale of yet more expensive and largely unnecessary nutritional/herbal supplements.
Dietitians remain one of the few healthcare practitioners consistently trained and qualified to evaluate detailed biochemistry of nutritional components and assess the systemic impact of said components on illness risk and yet, they are unbelievably under-utilized as part of a healthcare team. I believe this is largely due to the lack of education that other more dominant healthcare practitioners have not only regarding the importance of nutritional medicine itself but misunderstanding the application of customization for their individual patients and thus, not seeing significant clinical results. In other words, the healthcare providers at the helm dictating how a patient moves through the healthcare system simply don’t know what they don’t know. (We shall leave to another time the discussion of to what degree the subordinate role of the dietitian in medical care is attributable to the fact that its cohort is predominately female).
Regardless, under-utilization of the true scope of nutrition-based metabolic medicine is all-too-apparent, even among a population of competent dietitians. The true place of nutrition-based metabolic medicine is at the beginning of life and every step along the way, at the heart of prevention, treatment, and cure/management of a vast scope of illnesses and imbalances - many of which are currently not typically targeted with nutritional medicine at all. There are certainly no lack of success stories from patients who have used customized medical nutrition therapy to heal from advanced chronic illness.
As one patient - echoing the voice of so many - memorably wrote to me:
“At first, it was really hard for me to feel motivated to pay more attention to what I ate because I was too sick and tired to even try to think about it. Besides, I had already tried every kind of diet advice out there for years and nothing helped. But when we built this new plan that was made just for me, it was unlike anything I had seen before so I wondered if it would be different. I managed to make the first few small changes for the better with my food and I noticed it made a big difference in how much I could concentrate or have energy to shop and cook more. Then it was like - the better I felt, the more motivated I was to do the things that helped me to continue to eat better and the cycle just went up from there. I feel the best I’ve felt in decades. I can’t believe how no doctor had ever told me about this. I can’t believe how much money I wasted along the way. It makes me really angry that I had to suffer like that.”
How do we get everyone in the medical community to pay more attention to this? As a medical community, where do we go from here?
Getting Everyone On Board
So far, the science seems compelling enough to convince us all to jump on board. So why aren’t we? There are a lot of reasons.
It's hard to stare at a metabolic system and see it for its incredible complexity and avoid the pull to overly-reduce it to a single headline diagnosis that can be packaged and sent on its way with a bottle of pills. It's not only clinically difficult but it’s also not as profitable in the short term to treat people as metabolically complex individuals and resist the urge to prescribe a quick fix that can be standardized to the masses. And it’s not all the fault of the practitioners. It’s also the fault of the culture of medicine - driven in part by the patients’ expectations that they ought to invest as little energy or attention as possible to feel well. As odd as it may seem, there is a market for the rapidly-built flimsy house we talked about earlier. There are patients who really want to live in this house because it satisfies a short-term sense of relief and temporarily avoids deeper issues that seem harder to face. This house may fall down next week but who cares? Right now, they’ll feel better…mostly. Are you one of these people? Perhaps it’s time to reflect on that.
As a patient, we may have many reasons why it feels too uncomfortable to confront why we are unwilling to take greater ownership of our own health and invest in the time, persistence, and patience required to deeply heal. More interestingly perhaps, sometimes we are just too sick to be able to think clearly or comprehend complex ideas and manage multiple moving parts. Your metabolic health dictates a great deal about your comprehension and cognitive capacity. If you’re already struggling health-wise, it becomes this much harder to think your way out. This is one reason why sick people may have a relatively harder time getting better and healthy people take less work to stay healthy. Let us also not forget that quality affordable healthcare access in this country is about as rare as a genuine Sasquatch sighting.
Being faced with overwhelming socioeconomic barriers to achieving optimal health and wellness through health education and food access is one of - if not THE - most significant crisis within our modern society as a whole.
This leads us to another important broader system at play here: the system of societies/cultures and the infrastructures of access that we build and that all too often self-perpetuates negative return in terms of the well-being of its citizens. Appreciating this, it is very important to point out that individuals may not be able to practice optimal metabolic medicine for themselves without the broader support of their societies and communities. Inter-connectedness is the theme pervading not only the mechanics of how your body works to maintain health, but how our larger societies and environments support - or don’t support - those efforts. Federal policies governing healthcare access, funding for medical science research, and education are so important if we want to actively see change on a systemic level.
We must be aware of the personal choices we make each day that support or detract from these goals. Making “sustainable” choices in food and health doesn’t mean we need to go vegan (there are actually plenty of reasons why this approach isn’t as sustainable or as healthy as you might have been led to believe). But there are many ways we each vote with our dollars each day. Are we investing directly or indirectly in government representatives who support quality education/healthcare access for under-served communities? Are we knowingly participating in or contributing to businesses or marketing entities that undermine wellness in the community through resource exploitation? Are we understanding our role as inhabitants on a planet with limited and rapidly dwindling resources? Are we behaving responsibly with regard to managing those resources and decreasing the global burden? Or are we adding to it? Exploring the many components of global sustainability and health is of course beyond the scope of this post but will be explored more in future posts.
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After completing this 3-part series on Systems Medicine, I hope you’ve come away with much to ponder and much to feel excited about exploring! Most importantly, I want you to feel reinvigorated to be inquisitive, unwilling to accept misdirected spot treatments from your healthcare providers, and curious to take a deeper look into your own very unique biochemistry and symptoms and the important clues they hold. The incredibly customized wisdom contained within your own body often exceeds that of any provider’s medical training. As competent clinicians, it should be our sole job to help you interpret your own body’s wisdom and decode the clues it provides, not to override, suppress, or otherwise silence it.
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